BACKGROUND: The prognosis difference based on the depth of tumor muscularis propria invasion in gastric cancer (GC) was still debated, and therapy strategy for stage IB GC patient required further investigation.
METHODS: A total of 380 patients with pT2 GC after radical surgery were retrospectively analyzed, including 185 in superficial muscularis propria (sMP) group and 195 in deep muscularis propria (dMP) group.
RESULTS: The overall survival (OS) was significantly better for patients in sMP group than for patients in dMP group (P = 0.007). In multivariate analysis, depth of tumor invasion, pN stage, age, primary location, positive expression of p53, elevated maximal LDH, elevated initial CA19-9 and AFP level were independent prognostic factors for OS. The sMP group had a significantly better OS than dMP group (P = 0.014) in pN0 stage. After further stratification, the survival outcomes were not significantly different between deep muscularis propria tumor invasion without lymph node metastasis (dMPN0) group (stage IB) and superficial muscularis propria tumor invasion with stage 1-2 lymph node metastasis (sMPN1-2) group (stage II) (P = 0.100). Patients with adjuvant chemotherapy had a statistically better survival than those without in dMPN0 group (P = 0.045) and dMPN0 patients with adjuvant chemotherapy had better OS than sMPN1-2 patients (P = 0.015). In addition, greater postoperative survival could be observed in sMPN0 patients than dMPN0 patients in p53-positive group (P = 0.002), and similar OS could be seen between dMPN0 patients with p53-positive and T2N1-2 patients (P = 0.872).
CONCLUSIONS: As a unique subclassification of stage IB GC, appropriate adjuvant chemotherapy should be considered for patients with dMPN0 stage. In addition, positive expression of p53, elevated LDH could be potential factors in identifying the different prognoses for stage IB GC patients.

BACKGROUND: The trends in usage of tumor markers, including CEA, SCC, NSE, Cyfra21-1, and ProGRP, in Chinese lung cancer patients in the real-world setting are not fully investigated.
METHODS: A retrospective descriptive study was conducted using the database of Qilu Hospital of Shandong University, China between January 2013 and December 2017, involving patients primarily diagnosed with NSCLC or SCLC. Utilization trends by first discharge year, utilization rates within different durations before and after first discharge date, and combined utilization patterns of multiple tumor markers were analyzed.
RESULTS: The utilization of all these tumor markers showed increased from 2013 to 2017. CEA, Cyfra21-1, and NSE were the most frequently detected, which increased slightly from around 50% in 2013 to around 78% in 2017 in NSCLC and from around 70% in 2013 to around 92% in 2017 in SCLC. CEA, Cyfra21-1, and NSE were the most commonly measured within 3 months before first diagnosis with approximately 65% in NSCLC and 80% in SCLC, and ProGRP had the lowest utilization (around 30%). CEA, NSE, and Cyfra21-1 had the highest utilization rates after first diagnosis with both around 80% in NSCLC or SCLC. Combined usage of five tumor markers was ranked the first pattern in combined utilization.
CONCLUSIONS: This study suggests CEA, Cyfra21-1, and NSE are the most frequently detected before or after first diagnosis of NSCLC or SCLC. However, SCC and ProGRP tests appeared to have relatively low usages. The utilization pattern was consistent with recommendations of guideline, but underutilization still existed.

UNASSIGNED: Low-grade appendiceal mucinous neoplasm (LAMN) is a rare disorder. There is no consensus on the prognosis and management of LAMN.
UNASSIGNED: We reviewed 51 consecutive patients with LAMN from 2013 to 2018. We divided our patients into two groups. The first is patients with an intact appendix. The second group comprises patients with the potential to develop a malignant condition. Comparisons of serum tumor markers between two groups were performed. Survival curves were estimated. Univariate and multivariate Cox proportional hazards were computed for 46 patients with median follow-up of 2.7 years.
UNASSIGNED: Comparison of patients in two groups revealed significant differences in the mean level and abnormal ratio of CA125 (p < 0.001, p < 0.001), CA19-9 (p = 0.04, p = 0.04), and CEA (p = 0.001, p = 0.02). Eight patients had relapsed by the last follow-up in the second group. Patients with normal CEA had significantly longer disease-free survival (DFS) time than those with abnormal CEA (p = 0.04). CA19-9 exhibited a significant association with DFS (HR = 5.72, p = 0.02) in the Univariate Cox proportional hazards.
UNASSIGNED: The prognosis of LAMN is related to serum tumor markers, the surgical procedure and the pathology.

Objective: To investigate the diagnostic value of serum α-enolase (ENO1) in the primary hepatocellular carcinoma. Methods: From May 2012 to March 2017, 163 cases with liver diseases who met the inclusion and exclusion criteria were admitted to the Infectious Diseases Department of the General Hospital of Ningxia Medical University. Among them, 28 cases were of chronic hepatitis B (CHB), 31 cases with liver cirrhosis (LC), 104 cases with hepatocellular carcinoma (HCC), and 18 healthy volunteers (NC). Patient data and serum samples were collected and liver disease related indicators were measured to detect ENO1 levels with enzyme-linked immunosorbent assay (ELISA). The measured indicators were expressed in median. Mann-Whitney U nonparametric test was used to analyze the differences between the data. A Spearman\'s correlation analysis was used for bivariate correlation analysis. The sensitivity and specificity of ENO1 and alpha-fetoprotein in the diagnosis of liver cancer were analyzed by ROC curve. Results: Serum level of ENO1 in CHB group, LC group and HCC group was significantly higher than normal group. Serum level of ENO1 in HCC group was higher than CHB group (P = 0.001) and LC group (P < 0.01). Area under the curve (AUC) for serum ENO1 and alpha-fetoprotein were 0.782 (cut-off value 75.96, P = 0.000 1) and 0.800 (cut-off value 27.02, P = 0.000 1), respectively. There was a positive correlation between ENO1 and AFP (P = 0.001). The combined detection had significantly improved the detection efficiency (AUC = 0.835). Serum ENO1 was statistically significant (P < 0.05) in HCC tumor size (AUC = 0.663), tumor metastasis (AUC = 0.681), TNM stage (AUC = 0.710, stage I vs. II), and Edmondson grade (AUC = 0.685) (P < 0.05) and the elevated levels of ENO1 had significantly reduced (P < 0.05) the survival time. Conclusion: ENO1 can be a new candidate marker for the diagnosis of early stage HCC and its progression.
目的： 探讨血清α-烯醇化酶（ENO1）在原发性肝细胞肝癌诊断中的价值。 方法： 收集2012年5月-2017年3月入住宁夏医科大学总医院感染性疾病科并符合纳入与排除标准的肝病患者163例，其中慢性乙型肝炎（CHB）组28例，肝硬化（LC）组31例，肝癌（HCC）组104例；另收集对照健康志愿者（NC）组18例。采集血清标本用酶联免疫吸附法检测血清ENO1水平，收集患者资料，并检测肝病相关指标，测定指标均用中位数表示，采用Mann-Whitney U非参数检验进行资料间的差异分析；采用双变量斯皮尔曼相关性检验进行相关性分析；采用ROC曲线分析ENO1、甲胎蛋白在肝癌诊断中的敏感性和特异性。 结果： ENO1血清水平在CHB组、LC组、HCC组显著高于正常人群，HCC组ENO1血清水平高于CHB组（P = 0.001）及LC组（P < 0.01）。血清ENO1、甲胎蛋白在本组HCC诊断中曲线下面积（AUC）分别为0.782（界值75.96，P = 0.000 1）、0.800（界值27.02，P = 0.000 1），ENO1与AFP呈正相关（P = 0.001），联合检测能够显著提高检测效率（AUC = 0.835）。血清ENO1在HCC肿瘤大小（AUC = 0.663）、肿瘤是否转移（AUC=0.681）、TNM分期（I、II期比较，AUC = 0.710）、Edmondson分级（AUC = 0.685）中差异有统计学意义（P < 0.05）；高水平ENO1生存期显著降低（P < 0.05）。 结论： ENO1能够成为一种新的早期肝癌及肝癌进展的候选诊断标志物。.

The differential diagnosis between diffuse malignant peritoneal mesothelioma (DMPM) and other peritoneal surface malignancies (PSM) is still challenging. Serum mesothelin and osteopontin are increasingly used as markers of pleural mesothelioma, but their role in DMPM is unclear. We assessed the diagnostic and prognostic values of mesothelin, osteopontin, CEA, CA19.9, CA125, and CA15.3 in DMPM patients.
Markers were dosed before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) by enzyme-linked immunosorbent assay (ELISA) in 30 DMPM patients and 14 controls with other PSMs. Receiver-operating characteristics (ROC) curve were plotted. The performance of each marker was assessed by the area under the ROC curve (AUC-ROC).
Mean mesothelin levels were 7.84 ng/dl (SD = 5.14) in DMPM group and 3.00 ng/dl (SD = 1.25) in controls (P = 0.001). Mean CEA levels were 5.3 ng/dl (SD = 4.7), and 61.96 ng/dl (SD = 112.5) in the two groups (P = 0.008). No statistical difference was seen for osteopontin (P = 0.738), CA19.9 (P = 0.081), CA125 (P = 0.600), and CA15.3 (P = 0.365). AUC-ROC was 0.836 for CA19.9, 0.812 for mesothelin, 0.793 for CEA, and lower for CA125 (0.652), osteopontin (0.531), and CA15.3 (0.481). Using diagnostic cut-offs selected by ROC methodology, sensitivity, specificity, positive and negative predictive values were 70.0%, 100.0%, 100.0%, and 60.9% for mesothelin >5.21 ng/dl, and 90.0%, 85.7%, 93.1%, and 80.0% for CA19.9 < 8.8 U/dl. At multivariate analysis, osteopontin correlated with survival (hazard rate 6.46; 95%CI 1.81-23.05; P = 0.004).
When assessing PSMs of unknown origin, elevated mesothelin with low CA19.9 may increase the suspicion index for DMPM. Ospeopontin warrants further investigations as a prognostic marker for DMPM.

Cholangiocarcinoma is a malignant tumor of the liver arising from the bile duct epithelium, accounting for 10-25% of all primary hepatic cancers. The clinical presentation of this tumor is not specific and the diagnosis of early cholangiocarcinoma is difficult, especially in patients with other biliary diseases. Measurement of serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) are commonly used to monitor response to therapy, but are also useful for confirming the presence of a cholangiocarcinoma. In this setting, other biomarkers have been previously tested, including cytokeratin-19 fragment (CYFRA 21-1) and the matrix metalloproteinase-7 (MMP7). The purpose of this retrospective study was to determine the clinical usefulness of the assay of serum CEA, CA 19-9, CYFRA 21-1 and MMP7, individually and together, as tumor markers for the diagnosis of cholangiocarcinoma. Twenty-four patients (14 men, 10 women, 62.6±8.2 years of age) with histologically-confirmed cholangiocarcinoma (cases) and 25 age- and sex-matched patients with benign liver disease (controls) underwent measurement of these biomarkers. The mean values of all serum markers of patients with cholangiocarcinoma were significantly higher (p<0.01) than that of the controls. No correlation was found between serum tumor markers and total bilirubin, aspartate aminotransferase (AST) and alkaline phosphatase (ALP). The sensitivity, specificity and accuracy were: CEA: 52%, 55%, and 58%; CA 19-9: 74%, 82% and 78%; CYFRA 21-1: 76%, 79% and 78%; MMP7: 78%, 77% and 80%, respectively. The combination of all serum markers afforded 92.0% sensitivity and 96% specificity in detecting cholangiocarcinoma, showing the highest diagnostic accuracy (94%). In conclusion, our preliminary results suggest that the measurement of all four biomarkers together can help in the early detection of cholangiocarcinoma.